treating phobias

• Systematic desensitisation (SD) is a behavioural therapy based on classical conditioning, gradually alleviates phobic anxiety by pairing relaxation with the phobic stimulus, termed counterconditioning. The process involves constructing an anxiety hierarchy, teaching relaxation techniques (e.g. deep breathing), and exposing the client to the stimulus incrementally while relaxed. This exposure will follow the hierarchy from least fearful situation (e.g. picture of spider) to most fearful (e.g. real spider).
• In contrast, flooding, another exposure-based therapy, immediately confronts individuals with the phobic stimulus, often leading to rapid extinction of phobic responses. Though more intense and longer, flooding can swiftly halt phobic reactions by removing the option of avoidance behaviour. This rapid stop of phobic responses, termed extinction, occurs as clients learn the harmless nature of the stimulus without avoidance. However, flooding can be distressing, necessitating informed consent and thorough preparation to deal with its traumatic nature. 
• Typically, clients choose between systematic desensitisation and flooding based on their preference and therapist guidance. 
• Point: One strength of systematic desensitisation (SD) is the evidence base for its effectiveness.

  Evidence: Lisa Gilroy (2003) followed up individuals treated with three 45 minute SD sessions for spider phobia and demonstrated increased fear reduction compared to a control group

  Explain: In addition, a recent review showed SD is effective for specific phobias, social phobia, and agoraphobia

  Link: Therefore, this suggests that SD is likely to be beneficial for individuals struggling with phobias.
• Point: A further strength of SD is its applicability to individuals with learning disabilities.

  Evidence: Cognitive therapies may be challenging for individuals with learning disabilities, making SD a more suitable option. 

  Explain: Additionally, flooding might be overwhelming and confusing for this population.

  Link: Thus, This suggests that SD is often the most appropriate treatment for individuals with learning disabilities who have phobias, considering their unique cognitive and emotional needs.
• Point: One strength of flooding is its high cost-effectiveness.

  Evidence: Flooding can achieve results in as little as one session, making it more cost-effective compared to longer therapies like SD. 

  Explain: This ensures that more individuals can be treated within the same budget.

  Link: Therefore, this suggests that flooding can be a preferred choice in health care systems where cost-effectiveness is a priority.
• Point: One limitation of flooding is its highly unpleasant nature.

  Evidence: Schumacher (2015) found flooding to be significantly more stressful than SD for both participants and therapists.

  Explain: This raises ethical concerns regarding the distress caused by flooding therapy and its impact on client retention.

  Link: Consequently, therapists may be reluctant to use flooding due to its negative effects and higher dropout rates compared to SD